重度颅脑损伤患者并发发热相当常见,发热患者呈植物人状态或病死率高达28％～ 72％,单因素统计分析发热与病死率呈正相关.常见的发热原因,一类是与颅脑损伤相关的非感染性发热,包括中枢性发热、脱水热、吸收热、再出血发热等.其中颅脑损伤后导致的中枢性高热体温常高这39℃以上,高热可使原有的基础疾病加重,发生呼吸循环衰竭等并发症,如果得不到及时有效的治疗,很快就危及患者生命.另一类是与感染相关的感染性发热,由于颅脑损伤患者具有病情重、住院时间长、手术创伤大、侵入性操作多、昏迷及长期卧床等高危因素,易发生手术部位和肺部等部位的医院感染.该文通过复习国内外文献及专家共识,旨在了解颅脑损伤患者发热的机制与特点,对此早期诊断和治疗,以减轻继发性的脑损害,降低致残率,提高生存率.%Fever in patients with severe craniocerebral injury was a frequent occurrence.The rate of fever patients lead to plant man or death high up to 28％-72％.The univariate analysis found that there was significant association between fever and motality.One of the common cause of fever was non-infectious fever,which related with craniocerebral injury,including central fever,dehydration fever,clonus and rebleading fever.The major complication was central high fever after servere craniocerebral injury.The temperature high up to 39 ℃,which aggravated the original basic diseases,lead to respiratory and circulatory failure.Another cause of fever was infection fever which associated with nosocomial infection.Serious disease,long hospiltal stay,high proportion of invasive operation,coma were the high risk factors of patients with craniocerebral injury.The major type of nosocomial infection were pudmonary infection and surgical site infection.By reviewing domestic and foreign literatures and expert consensus,this article was intended to explore the characteristics and mechanism of fever in patients with craniocerebral injury.In order to reduce the secondary brain injury,decrease the disability rate,increase the sutrvival rate,diagnosis and treatment should be taken early.
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